An introducer is an elongated tubular member, which in the medical field is used to gain access to a particular site within a patient's body. It should be noted that herein the term “introducer” is, unless otherwise indicated, used as indicative of an introducer sheath, which comprises at least one proximal entry port. Depending on the medical procedure, the design of an introducer can vary. For example, the proximal end can comprise attachment means, usually referred to as “hubs,” for a medical instrument. Additionally, an entry port can comprise sealing material to prevent leakage of, for example, bodily fluids; and an introducer can comprise several entry ports. Further, different introducer manufacturers have different designs for their introducers.
Usually the medical procedure wherein an introducer is used commences with a puncture operation, in which a hollow needle is introduced at a point on a patient's skin, and is then advanced through tissues beneath the skin to the desired position in the organ of interest, e.g. a blood vessel. Typically a guide wire is then introduced through the needle, whereupon the needle is removed, leaving only the guide wire in place. Then an introducer, usually together with a dilator, is advanced over the guide wire. After removal of the guide wire and dilator, access to the organ has now been obtained through the lumen of the tubular introducer sheath.
The procedure described above can be used to gain access to a blood vessel for performing different types of intravascular operations. When the operation in question is completed, the puncture hole in the blood vessel can be sealed by means of a closure device, wherein an inner member of said closure device is positioned at an inner surface of the vessel wall by means of an insertion instrument and which is held in place by a suture or filament. The suture or filament extends from the closure device, through tissue overlying the vessel, and out of the skin surface. An example of this sealing technique is disclosed in U.S. Pat. No. 4,744,364. Another method, wherein an anchor is placed at an inner surface of a vessel wall and a sealing member is placed at an outer surface of the vessel wall, is disclosed in U.S. Pat. No. 5,021,059. These publications are hereby incorporated by reference for the devices and methods described therein.
In many cases several different medical procedures need to be performed on a patient using the same access site, e.g. a percutaneous blood vessel puncture. Some examples of different procedures involving such a percutaneous puncture are insertion of and measurements using a sensor guide wire, placing a stent, performing angioplasty, and, in most cases, sealing the puncture, as described above. Especially in the case of sealing a puncture, which follows subsequently to one or several different medical procedures, a need arises to switch introducer sheaths, due to specific requirements on, for example, the access path of the closure device in question.